"Blatant violations of pictorial warnings on tobacco products in India": Study

"Blatant violations of pictorial warnings on tobacco products in India": Study

The Ministry of Health and Family Welfare, Government of India (MOHFW, GOI) had mandated that all tobacco products manufactured/ packaged/ imported in India on or after 31 May 2009 have to display pictorial health warnings, as specified in the notification dated 15 March 2008.

However, a civil society led monitoring exercise has revealed blatant violations that are taking place across India, in the enforcement of this crucial public health and corporate accountability provision of the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003. A total of 60 tobacco product packages (from 9 states of India), manufactured on or after 31 May 2009 were analyzed (17 smoking forms and 43 smokeless forms). These products were purchased from retail sale outlets from 15 July 2009 onwards, considering that the already existing old stock of products available in the market would need a period of 4-6 weeks to be exhausted.

On close scrutiny, it has been revealed that a majority of the tobacco packs analyzed either do not display any pictorial warnings at all or the warnings displayed are not in conformity with the rules notified by the Government.

"The intent with which this provision was notified is not being fulfilled. The coming into force of the warnings was already delayed by two years and now this provision is ineffectively enforced. The notification 30 dated July 2009 which notified the officers responsible for implementing the packaging and labelling rules came two months after the enforcement date of this provision of the law. By then most tobacco product manufacturers had violated this law" said Monika Arora, Director, HRIDAY.

Some of the key deficiencies reported in this study include:

* Size of the pictorial warning: Pictorial warnings are occupying less than the stipulated 40% of the principal display area of the pack. Of the 60 products analyzed, 25 brands of gutka, 10 brands of khaini and 2 brands of bidi carry smaller warnings.

* Misleading descriptors on the pack: These are prohibited but still appear on some of the tobacco products analyzed. Five cigarette brands and 4 chewing tobacco brands contain such descriptors.

* Promotional messages on the pack: Messages promoting tobacco use appear on the packs of 10
brands.

* No pictorial warnings: Several tobacco products do not display any pictorial warnings at all. Eight brands of chewing tobacco and 9 brands of smoking forms of tobacco do not have any warnings. These include international brands as well.

* Incorrect warnings: Three brands were found carrying incorrect warnings

* Language: In some of the products, the warnings are not displayed in the regional language in which the brand name is mentioned, as mandated by the law.

"Some gutka companies are again circumventing pictorial warnings by covering 40% area of the pack with white colour and devoting much less space to the warning. The Government should hold them accountable in interest of public health and social justice" said Bobby Ramakant, Indian Society Against Smoking, Asha parivar.

"Enforcement of pack warnings is very weak in Kerala especially on bidi and chewing tobacco product packs. Today also lakhs of packets of Dinesh Bidi come to the market without pack warnings. The reason told by the company is the bulk stock of non-warning wrappers. The Government’s inaction on the violation reflects its attitude towards the health of the people" said Saju Itty, Executive Officer, Kerala Voluntary Health Services (KVHS).

"It is almost scandalous that even after such a long time many tobacco products do not carry stipulated warnings and those who carry it, try to circumvent the rules in every possible way. This situation has developed because word 'sold' used in the gazette notification was changed to the word 'manufactured/ imported' in the public notices issued by the ministry. This has clearly sent wrong signals to the industry about the seriousness of the implementation" said Dr PC Gupta, Director, Healis- Sekhsaria Institute for Public Health, Mumbai.

These violations have been documented and the report has been submitted to MOHFW, GOI, with a request to take cognizance of these violations and ensure that continuance and reoccurrence are prevented.

A set of recommendations have also been submitted to the Government to upscale the enforcement of pictorial warnings. These include:
- Introduction of a complaint mechanism
- Constitution of Inspection and Compliance Cells (ICCs)
- Issuing compliance guidelines for manufacturers, distributors and retailers of tobacco products
- Uniform placement of pictorial health warnings on all tobacco packs, preferably on the top edge of the pack
- Mandatory depiction of the warnings in at least one regional/local language specific to the region of sale

Civil society organizations are keen to work in partnership with the Central and State Governments to take stock of violations, improve enforcement and increase compliance at all levels. This includes the development of a thorough nation wide enforcement mechanism based on the recommendations submitted for the Government's perusal.

This study was collaboratively undertaken by Advocacy Forum for Tobacco Control (AFTC) member organizations: Cancer Foundation of India, West Bengal; Healis Sekhsaria Institute for Public Health, Maharashtra; Health Related Information Dissemination Amongst Youth (HRIDAY), Delhi; Indian Society against Smoking ,Uttar Pradesh; Institute of Public Health, Karnataka; Dr Mira Aghi, Delhi; National Organisation For Tobacco Eradication (NOTE), Goa; Rajasthan Cancer Foundation, Rajasthan; Taleem Research Foundation, Gujarat; Voluntary Health Association of India, Delhi and Kerala Voluntary Health Services, Kerala.